PCDS Newsletter: Report from the 69th Scientific Sessions June 5–9 2009, New Orleans, Louisiana

This meeting was held over a long weekend in new Orleans, a hot humid city, only partially recovered from Hurricane Katrina. 

The main trials that were presented are summarised below as well as clinical updates discussed at the meeting.

RECORD study
The main message from this study is that although rosiglitazone does increase the risk of heart failure and some fractures, it does not increase the risk of overall cardiovascular morbidity or mortality compared with standard glucose-lowering drugs (Home et al, 2009).

BARI 2D trial
No definitive benefit was seen implementing an insulin-sensitising versus an insulin-providing strategy. Despite an overweighting of participants treated with rosiglitazone in this trial, no increased cardiovascular risk was seen, and interestingly, no excess fracture risk was seen in this patient population (Pop-Busui et al, 2009). 

The Look AHEAD trial
For the clinician in practice, the take-home messages in this study are that meal replacements are a valuable adjunctive technique for ongoing weight loss, and physical activity remains essential in successfully managing overweight people with diabetes (Wadden et al, 2009). 

Clinical updates discussed:

• It was suggested that bariatric surgery should be renamed metabolic surgery as it can resolve diabetes (220000 Americans underwent this surgery last year).
• Liraglutide may be slightly more effective than exenatide when compared head-to-head (Buse et al, 2009).
• In the FIELD study there were significantly fewer amputations in the fenofibrate group (Rajamani et al, 2009).
• Use of aspirin routinely in diabetes is still open to debate. 
• The results of the ASCEND study will add more evidence to 
• the debate.
• Posters confirmed that at least three more dipeptidyl peptidase-4 inhibitors, two more glucagon-like peptide-1 receptor agonists and inhaled insulin are all in phase 2 or phase 3 trials.
• The American Diabetes Association would like to use HbA_1c levels alone to diagnose diabetes. This is still being debated.